Provider Demographics
NPI:1306612056
Name:JEWELLS, DOROTHEA LATOYA
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:LATOYA
Last Name:JEWELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1143
Mailing Address - Country:US
Mailing Address - Phone:440-258-0361
Mailing Address - Fax:
Practice Address - Street 1:2709 COLLINS DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1143
Practice Address - Country:US
Practice Address - Phone:440-258-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide